Nursing Management Relating to Communication Case Study

Excerpt from Case Study :

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Assists staff to effectively supervise and delegate to other team members;

Models coaching and mentoring;

Effectively builds an cohesive nursing team; and Assists staff in managing conflict. (2003)

In relation to 'Caring for Self, Staff and Patients' the Nursing Leadership Institute Competency Model states the following key competencies and behaviors as being necessary:

Recognizes the importance of building a sense of community in the work environment;

Demonstrates supportive behaviors in working with staff;

Rewards and celebrates staff successes in a way that is meaningful to the staff member;

Works to build a 1:1 relationship with each staff member;

Takes time to learn about the families of staff;

Remains flexible and sensitive to staff scheduling needs;

Supports staff during difficult interpersonal times;

Values the opinions and diversity of staff;

Shows appreciation when staff work overtime or change their schedules;

Recognizes and supports family responsibilities and needs;

Demonstrates a commitment to personal wellness and work-life balance;

Promotes celebrations and activities to build a cohesive unit.

Models effective personal stress management

Effectively communicates the mission, vision and strategic goals of the organization

Considers the impact of unit decisions on the rest of the organization.

Expresses and builds concern for the organization's welfare.

Takes responsibility for building loyalty and commitment throughout the organization.

Helps staff understand the relationship between their work and organizational goals.

Stays updated about regulatory requirements and keeps staff informed of changes and impact on the clinical area.

Takes a proactive position during regulatory surveys

Encourages inspiring nursing leaders; and Promotes nursing as desirable profession. (2003)

The work of Montague Brown entitled: "Nursing Management: Issues and Ideas" relates that it is important to recognize the "crucial role of the first-line administrators - the head nurse coordinators and supervisors. They represent administration to staff RNs, physicians, patients and families of patients. They play a key role in improving and maintaining high levels of morale on a patient care unit - or destroying it. Good managers are made, not born." (Brown, p. 151) Brown expresses the importance of thoughtful recruiting of nurse managers as well as systematic development of their management skills.

The work of Dubnicki and Sloan reports a pilot study conducted for the purpose of exploring characteristics and competencies of outstanding nurse managers. The participants in the study were 24 nurse managers identified by their nursing directors as "solid or outstanding performers based on performance criteria. The nursing directors were also active participants in the study. The researchers used a combined method of structured individual interviews with the nurse managers and written questionnaires completed by the nursing directors of the nurse managers. The individual interview required the nurse managers to describe significant events in the past two years in their careers as nurse managers and how they handled them. The questionnaires asked the directors to rate 100 managerial behaviors, how often they witnessed the nurse manager display the behavior, and how important that behavior is in successfully performing the job of nurse manager." (1991)

The findings of this study relate a competency model for nurse managers which consists of the competencies as follows: (1) Directing others- ability to use the power of one's position in an effective and appropriate way, to enforce rules, to address other about performance problems, to set standards for behaviors, and to tell others what they must do; (2) Self-confidence- belief in one's own capability to accomplish a task and select an effective approach to a task or problem; willingness to exercise independent judgment; (3) Use of influence strategies- ability to develop and use effective strategies, i.e., planned sequences of actions or alternatives, to influence others; (4) Interpersonal sensitivity- ability to understand and interpret individuals' concerns, motives, and feelings of others and to recognize their strengths and limitations; (5) Initiative- self-direction as reflected by taking needed action before being asked or required to, by seizing opportunities, or by doing significantly more than what is minimally required; (6) Group management- ability to lead a group, encouraging members' participation, promoting cooperation and teamwork, reducing internal conflict, encouraging, their participation, treating them fairly and equitably, keeping them informed, and finding solutions that satisfy all involved parties; (7) Achievement orientation- desire to achieve, to commit oneself to accomplishing challenging objectives, or to compete against a defined standard of excellence; (8) Direct persuasion- ability to present a logical, compelling case; to convince others to support a recommended course of action; and (9) Analytical thinking- ability to break a complex problem, process, or project into its component parts and to consider the parts in a systemic way; to make systematic comparisons of different features or aspects (Dubnicki and Sloan, 1991).

The work of Squires (2001) provides a description of core competencies that were identified for nurse managers in a small acute care facility which was a rural 150-bed community hospital. The competencies identified and defined in this study included: (1) Staffing and Scheduling-consistently demonstrates effective management of staffing and scheduling needs of the unit based on budgeted patient care hours and patient acuity; (2) Organization and Delegation - demonstrates effective organization skills that promote unit operations. Delegates administrative tasks appropriately to members of the patient care unit willing to accept these types of duties in order to more effectively manage the patient care director workload; (3) Documentation- demonstrates appropriate use of documentation related to hospital and unit operations. Makes recommendations for changes in documentation to improve operations as needed; (4) Financial management- demonstrates appropriate use of financial management techniques when conducting unit operations, including budgeting, supply management, productivity measures, use of statistical methods where appropriate, reimbursement issues, and cost-benefit analysis; (5) Human resources management-effectively manages human resources in the patient care area, utilizing appropriate channel to ensure that unit and departmental needs are met; (6) Communication and Collaboration- demonstrates effective communication techniques with all members of the organization. Collaborates on an interdepartmental level to ensure smooth interdepartmental operations; (7) Leadership-demonstrates effective leadership in the patient care area that promotes departmental improvement, staff satisfaction, and interdepartmental relations. Includes the use of change and administrative theory when exercising leadership roles; (8) Computer skills- effectively uses computerized information resources to manage the patient care area; (9) Performance Improvement- reviews current departmental and unit-based performance improvement initiatives. Identifies areas for performance improvement and begins to initiate projects when appropriate; and (10) Staff Development- Through collaboration with the clinical development specialist, ensures that education and training needs of staff are met on a continuous basis during each calendar year. Personal development through continuing education is conducted independently and is based on personal and institutional needs (Squires, 2001).

The work of Snow (2001) reports a study in which leadership development outside of nursing in order to identify competencies required for excellent nursing leadership was conducted. Snow (2001) synthesized research which had been conducted over a five-year period in non-healthcare organizations relating to competencies of leadership that were held by excellent leaders in comparison to average leaders. The work of Snow (2001) states that "nursing lags behind other industries in teaching and supporting research-based leadership theory that is linked to performance." Key competencies identified in the work of Snow (2001) for excellent nursing leadership include: (1) emotional competencies (including interpersonal skills, innovation, effective leadership and networking); (2) empathy; (3) self-discipline; and (4) initiative. (Snow, 2001) the work of Snow (2001) placed an emphasis on emotional competencies as being essential in strong nursing leadership roles.

The work of Lin, et al. (2007) entitled: "Management Development: A Study of Nurse Managerial Activities" relates a study conducted in order to determine the important managerial roles of nurse management. This study was conducted through use of multiple items measures in order to "operationalize the manager roles and functions and adapt them to those used in a nursing context." (Lin, et al., 2007) Lin states: "...An empirical study of nurse managers' managerial activities and competencies was conducted via a mailed questionnaire, which was composed of two parts: basic data and management activities and required skills. Data were collected using a five-point Likert-type scale, where 1 is "strongly disagree" and 5 is "strongly agree." (2007) additionally related by Lin, et al. is that they were interested in "learning what nurse managers found most important in their work." (2007) Key questions asked in this study were: (1) What are the portfolios of critical management activities performed by nurse managers at different managerial levels? And (2) What are the critical skills required to perform these management activities effectively at each managerial level? (Lin, et al., 2007) Lin et al. (2007) states that one method of characterizing a nurse manager's work "...is in terms of the different roles he or she plays. Another way is based on the functions that the nurse manager performs. Relative to the tasks that managers perform." Lin et al. relates the work of Mintzberg (1980) who "...proffered ten interrelated…

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